Putting patients in the driving seat for hospital transport

New proposals to improve non-emergency patient transport services and make them more patient-centred

have been announced by Welsh Health Minister Edwina Hart. Non-emergency patient transport enables people to access outpatient, day treatment and other services at NHS hospitals. Around 1.4 million such journeys are undertaken every year.

Users of the service are often seriously ill, such as those needing dialysis or chemotherapy. They are usually vulnerable, with physical or other disabilities, and are dependent on such transport, as they often live in rural locations.

A review undertaken by Win Griffiths, Chairman of Abertawe Bro Morgannwg Health Board – commissioned by Mrs Hart and published today – says that the current system is fragmented, could be better managed and does not offer a patient-led service.

Examples of the service not being patient-centred include inconvenient and uncomfortable multiple-stop, long journeys for patients, seriously ill patients furthest away from the hospital being picked up first and dropped back home last, and carers not being able to travel with their patient.

The review proposes that four pilot projects road-test the best ways of delivering improvements, including:

better use of voluntary organisations to provide more services – currently, only seven per cent of journeys are undertaken by the sector;

cementing stronger management arrangements to ensure more co-ordinated provision between public service providers and voluntary organisations;

using other vehicles instead of minibuses for more comfortable modes of travel;

Each pilot will be to develop a partnership model, based around the central Health Board-Wales Ambulance Service Trust relationship, with a specific focus for each one – locality planning, rural service delivery, or development of the third sector. The pilots will be reviewed after 12 months.

Announcing a consultation on the review’s findings, Mrs Hart said:

“Non-emergency patient transport provides a vital service for thousands of patients across the whole of Wales.

“However, I commissioned this review because I was concerned that services were patchy across Wales and not patient-centred.

“Users are full of praise for the frontline staff and volunteers that deliver services, but they feel the current system itself is not geared to their needs.

“The pilot projects would look at testing out various approaches such as better use of community transport services, expanding provision from the traditional minibus service to more use of car services, and better procurement and leasing arrangements.

“Opportunities to integrate fleets across a range of providers – using vehicles from local government, NHS Health Board and WAST as well as the voluntary sector – will also be explored.

“I am especially keen for the voluntary sector and unions to engage, as key to the success of the proposed arrangements will be these groups. Currently, only seven per cent of journeys are undertaken by the voluntary sector but with 1500 such organisations in Wales – many of them willing to help deliver services – the potential for better utilisation of the sector is great.

“I am grateful to Win Griffiths for his thorough review. The NHS must aim to go beyond just delivering services to ensuring services are patient-led and of high quality. Non emergency patient transport is no exception and Win’s proposals have been drawn up with this firmly in mind.”

Mr Griffiths said:

“The review does not shrink from the fact that the service has been through periods of variable performance. The whole system must serve citizens better, and must be driven by citizens’ needs.

“With the structural reforms of NHS Wales, I am confident that – providing we can collectively generate the right partnership arrangements – the seven Health Boards, the ambulance service and partners in the third sector can deliver an improved service.

“The best way to manage the system and improve performance needs to be tested, hence the pilot studies to investigate how the service can be improved.”